Is hospitalization necessary after a heart attack?

Question

Hello doctor,

This query is regarding my 75-year-old father. He has been seeing the same doctor, who has recommended the same tests for each follow-up visit over the past five years. Initially, he saw the doctor once a year, but recently the visits have become quarterly. I have uploaded a copy of the blood test reports and the ECG done for the follow-up on the 8th of this month. Yesterday, he also had to undergo a confirmatory blood test (Troponin) and an ECG, which confirmed that he had a silent heart attack 10 days ago.

The admitting doctor, after reviewing the test results, recommended discontinuing Apixaban 2.5 mg (1-0-1) and starting Aspirin 150 mg (0-1-0) and Clopidogrel 75 mg (0-1-0). Additionally, he recommended an injection of Enoxaparin sodium 80 mg subcutaneously twice a day for five days. The doctor strongly advised hospitalization for at least a couple of days.

My questions are as follows:

Is hospitalization necessary now, or can we wait for five days since 80 mg of Enoxaparin sodium injections have been recommended?
What is the function of the Enoxaparin sodium 80 mg injection, and how does it work?
What is the purpose of hospitalization at this stage?
If we opt for hospitalization, what tests are likely to be conducted?
Why has the doctor advised hospitalization along with the Enoxaparin sodium 80 mg injections for five days?

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

So, he did not have any symptoms, and this was detected during routine blood testing, correct? His troponin level is elevated, which indicates he had a heart attack. Patients like this are typically admitted for observation and the administration of medications. We usually recommend admission immediately after a heart attack for five to seven days. However, since that time has already passed, admission is not absolutely necessary, but it is better for him to be admitted for observation, Enoxaparin sodium injections, and angiography.

He should undergo an echocardiogram (echo) and angiography, and hospitalization is required for angiography. Depending on the results of the angiography, he may need an angioplasty or bypass surgery. Additionally, if he experiences any warning signs such as low blood pressure or shortness of breath, he should be admitted. Enoxaparin sodium is a blood thinner that aids in the dissolution of an already-formed clot, which is the cause of a heart attack. Therefore, it should be administered after a heart attack.

I hope this helps you.

Thank you.